目的：探讨宫颈癌组织中miR-191的表达及其对患者预后的影响。方法: 选取2012年12月至2014年12月在新乡市 中心医院行手术治疗的107例宫颈癌患者的组织标本和46例行子宫肌瘤手术切除患者的正常宫颈组织标本（对照组）， 用qPCR 术检测癌组织中miR-191表达水平。术后第1天开始随访，随访截止日期2019年12月31日，所有患者均随访满5年，以死亡作为 终点事件，记录患者生存期和5年生存率，采用Kaplan-Meier法和Cox比例风险回归模型分别进行生存预后影响因素分析。结 果: miR-191在宫颈癌组织中的表达水平显著高于对照组（P<0.01）；是否高危HPV感染、不同病理分级、FIGO分期和是否发生淋 巴结转移的宫颈癌组织中miR-191表达水平差异比较有统计学意义（均P<0.01）。miR-191低表达组患者的5年生存率显著高于 高表达组（81.48% vs 33.75%, χ2=16.905， P<0.01）；病理分级、FIGO分期、淋巴结转移和miR-191表达是影响宫颈癌患者预后的风 险因素（HR=0.486、 3.065、 2.339和2.755， 均P<0.05）。结论: miR-191在宫颈癌组织中高表达，且随着疾病的恶性进展而表达水平 升高，有望成为宫颈癌早期诊断和预后评估的潜在生物标志物。

Objective: To investigate the expression of miR-191 in cervical cancer tissues and its effect on the patients' prognosis. Methods: One hundred and seven cervical cancer tissue specimens from patients who underwent surgical treatment and 46 normal cervical tissue specimens from patients who underwent surgical resection of uterine fibroids (the control group) in Xinxiang Central Hospital were collected from December 2012 to December 2014. The expression of miR-191 in cancer tissues was detected by qPCR. All patients were followed up from the first day after surgery, and the follow-up deadline was December 31, 2019. All patients were followed up for 5 years, with death as the end event. The survival time and 5-year survival rate of the patients were recorded. Survival analysis was performed using Kaplan-Meier method and the factors affecting survival prognosis were analyzed using Cox proportional hazard regression model. Results: The expression level of miR-191 in cervical cancer tissues was significantly higher than that in the tissues from control group (P<0.01). There were significant differences in miR-191 expression among patients with different high-risk HPV infection status, different pathological grades and FIGO stages, and different lymph node metastasis status (all P<0.01). The 5-year survival rate of patients in the miR-191 low expression group was significantly higher than those patients in the high expression group (81.48% vs 33.75%, χ2=16.905, P<0.01). Pathological grade, FIGO stage, lymph node metastasis and the expression of miR-191 were risk factors affecting the prognosis of cervical cancer patients (HR=0.486, 3.065, 2.339 and 2.755, all P<0.05). Conclusion: miR-191 is highly expressed in cervical cancer tissues, and its expression level increases with the progressionof malignancy. It is expected to become a potential biomarker for early diagnosis and prognosis evaluation of cervical cancer.

吴阶平医学基金资助项目（No.320.6750.14109）